An open and just environment

Staff should know that they are expected to 'do the right thing' even if that challenges the status quo. They should feel able to talk about, reflect on and challenge current practices without fear of personal repercussion. Organisations should adopt a non-punitive, learning approach to errors, and should instigate reflective mechanisms such as peer review. Staff need to be encouraged to use ‘trial and error’ and to experiment − without creating inappropriate risk for patients − with new ideas and ways of working.

Related publications

Patient-centred leadership

This report summarises the main findings of the Francis Inquiry into the failings of care at Mid Staffordshire in relation to NHS leadership and culture.

Enabling compassionate care in acute hospital settings

In December 2008 we published a review paper to launch the programme, Seeing the Person in the Patient, which drew on available published research.

Leadership and engagement for improvement in the NHS: together we can

This report makes the case for engaging staff, patients and boards, and for building relationships across systems of care.

Hospital Pathways programme: lessons learned

We describe the Hospital Pathways programme, the method used to evaluate it, what we learned about the approach, and how the lessons have influenced the Patient and Family-centred Care programme.

Related blogs

Why do people find it so hard to speak out in the interests of patients?

Health care staff are usually motivated to enter their professions by a desire to make a difference for patients and service users. Why then, do they find it so hard to speak up for patients?

We need to talk about frail older patients

Drawing on experience from our Point of Care programme, Jocelyn Cornwell explores the options to improving the poor results on care shown in the CQC report.

Anna Dixon

Are we expecting too much from the Care Quality Commission?

A Public Accounts Committee report has highlighted the challenges the CQC has faced since it was set up. But are we expecting too much from a quality regulator?

Related audio-slideshow

Creating a culture to ensure good patient safety, quality and experience

Julie Hendry, Director of Quality and Patient Experience at Mid-Staffordshire NHS Foundation Trust, explains how the culture of care has since been transformed to ensure patients are safe and well-cared-for.